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Veterans in Healthcare · 1 month ago

Revenue Cycle Specialist I Professional Billing and Collections

Yuma, AZ

Full-time

Onsite

New Grad, Entry Level

$17.67/hr - $25.98/hr

Veterans in Healthcare is seeking a Revenue Cycle Specialist I to perform billing and collection activities for various healthcare services. The role involves managing third party insurance billing, payer denial reviews, and providing customer service to patients regarding their accounts.

Health CareMilitary

Responsibilities

Perform initial billing on third party claims, either electronically or paper

Reviews and corrects all billable claims in billing software in accordance with payer-specific guidelines and billing requirements

Prepares and submits appropriate billing attachments as required by specific payors

Comply with all government and third-party payers regulatory mandated requirements for billing and collections

Perform timely and appropriate follow-up on unpaid, underpaid, suspended, and denied accounts, utilizing system work queues and/or reports, payer portals, etc

Performs outgoing calls to patients and insurance companies to obtain necessary information for accurate billing, collections and correction of denials

Prepare appeal letters, with appropriate supporting documentation to insurance carriers when not in agreement with claim denial

Reviews remittance advice to ensure payments are correct for services rendered and resolve payment discrepancies

Reviews credit balance accounts and take appropriate action to resolve the credit balance

Handle self-pay accounts, including financial assistance and collection agency assignment

Provides exemplary customer service to ensure that patients come first

Answers incoming patient phone calls and make outbound collection calls on open balances

Works with patients to set up appropriate payment plans on their accounts when applicable and follows up on past due payment plans

Identifies patients with potential financial hardship and qualifies for Financial Assistance (with all appropriate documentation)

Responsible for appropriate handling of bankruptcy and deceased accounts

Apply insurance payments, either electronically or from paper Explanation of Benefits (EOBs) against the appropriate account or line-item service and enters the adjustments, denial codes, copays, deductibles and co-insurance as indicated

Processes transactions in system by effectively and efficiently handling patient cash, check and credit card payments; to include daily posting of lockbox and patient electronic payment files, daily balancing and reconciliation of cash collected and prepare daily bank deposits, as appropriate

Handles the cash clearing and PLB accounts, undistributed payments, credit balancing activities along with determining and investigating unidentified accounts and processing refunds for patients and insurance companies

Organizes work and accomplishes results; prioritizes individual and departmental workload; handles multiple tasks simultaneously; follows up on assignments and meets deadlines

Maintains productivity and accuracy necessary to meet monthly collection goals

Models core values consistently

Sets an example with behavior and attitude that exemplifies an eagerness to satisfy, develop positive relationships with clients, patients, co-workers, payers, and enhance public relations through verbal communication

Projects a mature problem-solving attitude while dealing with interpersonal conflict

Contributes to team-building efforts within the department; interacts, communicates, and collaborates with team members to maximize group effectiveness; is a mentor and assists in training of fellow team members; addresses issues and concerns directly with coworkers to promote mutual respect within the work unit; contributes individually and/or through teams to the ongoing improvement of work processes

Other duties as assigned